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Biphosphonates-associated osteonecrosis of the jaw: the role of gene-environment interaction.

Biphosphonate (BPN) are widely used in clinics to treat metastatic cancer and osteoporosis thus representing a problem not only for patients but also for workers involved in their preparation and administration. A similar exposure occurred years ago in match-making workers undergoing bone alterations similar to those consequent to BPN exposure. Osteonecrosis of the jaw (ONJ) is a main adverse effect related to BPN administration, which is performed in millions of patients worldwide for osteoporosis and cancer therapy, thus representing an emerging problem in public health. In susceptible patie

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… Over-expression of TNF in the periodontium may be harmful to the host. Normally, TNF and other pro-inflammatory agents are regulated by IL-10, suggesting that some deficiency in this regulation mechanism may be linked to the disease. …

Molecular Mechanisms Leading from Periodontal Disease to Cancer.

Periodontitis is prevalent in half of the adult population and raises critical health concerns as it has been recently associated with an increased risk of cancer. While information about the topic remains somewhat scarce, a deeper understanding of the underlying mechanistic pathways promoting neoplasia in periodontitis patients is of fundamental importance. This manuscript presents the literature as well as a panel of tables and figures on the molecular mechanisms of Porphyromonas gingivalis and Fusobacterium nucleatum, two main oral pathogens in periodontitis pathology, involved in instigati

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… consists of the following categories: (1) gingival diseases (biofilm-induced or non-biofilm-induced); (2)periodontitis encompassing the following conditions: (a) necrotizing periodontal diseases, (b) periodontitis, c) periodontitis as a manifestation of systemic disease; (3) other conditions affecting the periodontium … Cheng et al. focused on the influence of periodontal disease on immune cells subsets and cytokines present in the peripheral blood by comparing the blood samples collected from patients with chronic or aggressive periodontitis with samples from participants with healthy periodontium [ 145 ]. …

Gut-Bone Axis: A Non-Negligible Contributor to Periodontitis.

Periodontitis is a polymicrobial infectious disease characterized by alveolar bone loss. Systemic diseases or local infections, such as diabetes, postmenopausal osteoporosis, obesity, and inflammatory bowel disease, promote the development and progression of periodontitis. Accumulating evidences have revealed the pivotal effects of gut microbiota on bone health via gut-alveolar-bone axis. Gut pathogens or metabolites may translocate to distant alveolar bone via circulation and regulate bone homeostasis. In addition, gut pathogens can induce aberrant gut immune responses and subsequent homing o

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… obesity-related periodontitis↓ PMO-related periodontitis | PMO rats, butyrate-producing bacteria↓, periodontitis severity↑; | Jia et al., 2019 , 2021 PMO rats with berberine or probiotics gavage, butyrate-producing bacteria↑, periodontitis severity↓ Periodontitis is a complex inflammatory condition in periodontium … Age-Related Changes of CD4(+) T Cell Migration and Cytokine Expression in Germ-Free and SPF Mice Periodontium. Arch. Oral. Biol. 87, 72–78. doi: 10.1016/j.archoralbio.2017.12.007 Iwami K., Moriyama T. (1993). …

Indian Society of Periodontology Good Clinical Practice Recommendations for dental pain management and use of analgesics.

Pain is one of the most frequent reasons for seeking dental care and significantly influences patient comfort, treatment acceptance, and clinical outcomes. Effective management of dental pain requires accurate diagnosis, timely intervention, and the rational use of analgesics supported by evidence-based clinical decision-making. Recognizing the need for structured guidance for everyday dental practice, the Indian Society of Periodontology has developed Good Clinical Practice Recommendations on Pain Management and the Use of Analgesics in Dental Clinics. These recommendations were formulated by

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… effective pain relief, preserves tooth structure, and improves overall patient outcomes and satisfaction. [75-79] Table 2 Differentiating periodontal versus pulpal pain TMJ – Temporomandibular joint | Pulpal pain | Periodontal pain Origin | Inflammation/infection of pulp | Inflammation/infection of the periodontium … movement Palpation of soft tissue (including lymph nodes) Palpation of cervical muscles and assessment of cervical range of motion Cranial nerve examination General inspection of the ears, nose, and oropharyngeal areas Examination and palpation of intraoral soft tissue Examination of the teeth and periodontium …

N-Glycosylation Alteration of Serum and Salivary Immunoglobulin a Is a Possible Biomarker in Oral Mucositis.

BackgroundOral and enteral mucositis due to high-dose cytostatic treatment administered during autologous and allogeneic stem-cell transplantation increases mortality. Salivary secretory immunoglobulin A (sIgA) is a basic pillar of local immunity in the first line of defense. Altered salivary sialoglycoprotein carbohydrates are important in the pathologies in the oral cavity including inflammation, infection and neoplasia. Therefore, we assessed whether changes in the salivary and serum IgA glycosylation correlated with development and severity of oral mucositis.MethodsUsing capillary electrop

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… A minority can be derived from the local PCs of the periodontium as well as serum through the gingival sulcus (crevicular epithelium) via paracellular passive leakage. sIgA- and IgA-producing B-cells have different glycosylation mechanisms and the expression of glycosyltransferases can be altered by …

The Influence of Local Pamidronate Application on Alveolar Dimensional Preservation after Tooth Extraction-An Animal Experimental Study.

The aim of this randomized, controlled animal exploratory trial was to investigate the influence of local application of aminobisphosphonate pamidronate during the socket preservation procedure. Mandibular premolars were extracted in five Göttingen minipigs. Two animals underwent socket preservation using BEGO OSS (n = 8 sockets) and three animals using BEGO OSS + Pamifos (15 mg) (n = 12 sockets). After jaw impression, cast models (baseline, eight weeks postoperative) were digitized using an inLab X5 scanner (Dentsply Sirona) and the generated STL data were superimposed and analyzed with GOM I

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… Although BPs’ systemic use may cause side effects as bisphosphonate-related osteonecrosis of the jaw (BRONJ) or esophagitis, topical application appears to have a positive effect on the health of the periodontium and bone formation [ 30 , 31 ]. …

Evaluation of Preventive Role of Systemically Applied Erythropoietin after Tooth Extraction in a Bisphosphonate-Induced MRONJ Model.

Background and Objectives: In this experimental study, the prophylactic effect of systemically administered erythropoietin (EPO) in medication-related osteonecrosis of the jaw (MRONJ) was evaluated. Materials and Methods: The osteonecrosis model was established using 36 Sprague Dawley rats. EPO was systemically applied before and/or after tooth extraction. Groups were formed based on the application time. All samples were evaluated histologically, histomorphometrically, and immunohistochemically. A statistically significant difference in new bone formation was observed between the groups (p <

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… bisphosphonates cause osteonecrosis, particularly in the jaw, previous MRONJ studies have discussed theories related to changes in bone remodeling, excessive suppression of bone resorption, inhibition of angiogenesis, micro-fracture of the bone due to continuous microtrauma, bacterial invasion through the periodontium …

Effect of leaving chronic oral foci untreated on infectious complications during intensive chemotherapy.

BackgroundLeukaemic patients receiving intensive chemotherapy and patients undergoing autologous stem-cell transplantation (ASCT) are routinely screened for oral foci of infection to reduce infectious complications that could occur during therapy. In this prospective study we assessed the effect of leaving chronic oral foci of infection untreated on the development of infectious complications in intensively treated haematological patients.MethodsWe included and prospectively evaluated all intensively treated leukaemic patients and patients undergoing ASCT who were referred to our medical centr

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… Periapical granuloma | 10 (36) | 10 (29) Initial endodontic treatment | 2 (7) | 0 (0) Furcation involvement | 2 (7) | 2 (6) Retained roots | 2 (7) | 1 (3) Fully or partially impacted teeth | 3 (11) | 3 (9) Caries profunda | 2 (7) | 1 (3) Follicular cyst | 0 (0) | 2 (6) Periodontal condition Healthy periodontium …

Diagnostic benefits of platelet-to-lymphocyte, neutrophil-to-lymphocyte, and albumin-to-globulin ratios in dogs with nasal cavity diseases.

BACKGROUND: A multimodal approach for diagnostic tests under anesthesia is required to diagnose nasal cavity pathology (NP) reliably in dogs. Blood test results may provide clues to the suspected NP. METHODS: This prospective blinded study assessed 72 dogs with chronic nasal discharge due to NPs, and 10 healthy dogs as the control group (CG). NPs were diagnosed using whole-body computed tomography (CT), upper airway endoscopy, examination of nasal mucosal swabs by bacterial and fungal culture, and histopathological examination of nasal mucosa biopsies. The exclusion criteria were the presence

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… In addition to rhinoscopy, nasal swabs and histopathology, CT of the head is necessary to evaluate the nasal cavity, periodontium, paranasal sinuses, and bony structures in diagnosing nasal cavity disease for optimal diagnosis [ 1 , 3 , 5 ]. …

Comparison of the Effectiveness of Conservative and Surgical Treatment of Medication-Related Osteonecrosis of the Jaw: a Systematic Review.

OBJECTIVES: The objective of this systematic review is to evaluate the current knowledge on the effectiveness of conservative and surgical treatment of medication-related osteonecrosis of the jaw. MATERIAL AND METHODS: MEDLINE (PubMed), ScienceDirect and Cochrane Library search in combination with hand-search of relevant journals was conducted including human studies published in English between January 2017 and February 2023. Studies assessing treatment strategies for medication-related osteonecrosis of the jaw (MRONJ) were included. Quality and risk-of-bias assessment were evaluated by Joan

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… One of the first aims of this study was to analyse the effects of bisphosphonates and other antiresorptive drugs on the periodontium, but due to limited resources, the systematic review of the literature was linked to the aspect of treatment strategies for MRONJ. …

Neoplastic Disorders and Cardiovascular Comorbidities in Geriatric Patients: A Simple Association?

Cardiovascular disease (CVD) and cancer frequently coexist in older patients, posing significant challenges in clinical management due to overlapping risk factors and treatment-related complications. This narrative review summarizes current knowledge on the epidemiology, shared pathophysiological mechanisms and clinical impact of neoplastic comorbidities in older adults with cardiovascular diseases. It highlights the increased mortality, morbidity and diminished quality of life resulting from the coexistence of these conditions. The review also discusses personalized management strategies, emp

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… Ageing and Inflammation: What Happens in Periodontium? Bioengineering. 2023;10:1274. doi: 10.3390/bioengineering10111274. 27. Araújo G.R.L., Marques H.S., Santos M.L.C., da Silva F.A.F., da Brito B.B., Correa Santos G.L., de Melo F.F. …

Oral Mucositis Induced By Anticancer Therapies.

Oral mucositis induced by conventional cytotoxic cancer therapies is a common and significant clinical problem in oncology. Mucositis symptoms, which include severe pain, may lead to dose reductions and unplanned interruptions of chemotherapy and/or radiotherapy, and often affect patients' quality of life. In addition, ulcerative mucositis represents a risk factor for local or systemic infectious complications that may be life-threatening in immunosuppressed patients. The development of biologically based targeted cancer therapies, which aim to block the growth, spread, and survival of tumors

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… There is evidence to suggest (albeit from small studies) that an infected and inflamed periodontium is associated with increased severity of OM [ 24 •, 38 – 41 , 81 ]. …

Oral foci of infection and their relationship with hospital stay after haematopoietic cell transplantation.

PurposeOral focus screening is recommended before HCT (haematopoietic cell transplantation). Acute foci are generally treated pre-HCT. However, it is unclear whether chronic foci should be treated pre-HCT. This study aimed to evaluate the association between number of foci and early post-HCT morbidity and mortality.MethodsPatients who received an oral screening pre-HCT at Radboudumc between 2013 and 2023, with a recent panoramic radiograph, were included. Foci were defined as teeth or implants with deep pockets, furcation radiolucencies, periapical radiolucencies, deep caries, partial eruption

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… An intraoral inspection of mucosae, dentition and periodontium was performed, supplemented with a panoramic radiograph (if already present, used if no more than 6 months old) and occasionally periapical radiographs. Dental care was provided if deemed necessary and possible. …

Photobiomodulation in Medication-Related Osteonecrosis of the Jaw: Outcomes in Stage I and Its Adjunctive Role in Advanced Cases.

Background/Objectives: The development of pharmacotherapy, particularly in antiangiogenic drugs, has led to the emergence of MRONJ as a significant side effect. With the increasing incidence of cancer, the management of MRONJ poses a growing challenge for clinicians. The aim of the study is to evaluate the effectiveness of photobiomodulation (PBM) in treating patients with stage I, II, and III medication-related osteonecrosis of the jaw (MRONJ). Methods: A total of 31 patients were divided into two groups: Group 1 (n = 14 patients), with Stage 1 MRONJ; and Group 2 (n = 17 patients), with Stage

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… Bisphosphonates and Periodontics: Potential Applications for Regulation of Bone Mass in the Periodontium and Other Therapeutic/Diagnostic Uses. J. Periodontol. 2002;73:813–822. doi: 10.1902/jop.2002.73.7.813. 16. Frith J.C., Mönkkönen J., Blackburn G.M., Russell R.G.G., Rogers M.J. …

Periodontal Disease as a Risk Factor for Rheumatoid Arthritis: A Systematic Review.

REVIEW OBJECTIVE: The objective of this systematic review is to identify and synthesise the best available evidence to examine whether perio … tor alpha (TNF- α). These cytokines are thought to stimulate resident cells in the synovium and the periodontium to produce MMPs mediating connective tissue destruction, and induce the differentiation and activity of osteoclasts to destroy bone In particular, TNF-α, also promotes bone resorption: (i) by up-regulating inducible nitric oxide synthase (iNOS) and …

Anti-resorptive therapy in the osteometabolic patient affected by periodontitis. A joint position paper of the Italian Society of Orthopaedics and Traumatology (SIOT) and the Italian Society of Periodontology and Implantology (SIdP).

This joint report from the Italian Society of Orthopaedics and Traumatology (SIOT) and the Italian Society of Periodontology and Implantology (SIdP) aims for a consensus around the scientific rationale and clinical strategy for the management of osteoporotic patients affected by periodontitis who are undergoing anti-resorptive (AR) therapy to manage the risk of the occurrence of a medication-related osteonecrosis of the jaws (MRONJ). Osteoporosis and periodontitis are chronic diseases with a high prevalence in aging patients, and they share some of the same pathogenetic mechanisms based upon i

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… After periodontal therapy, the clinician can face two different levels of disease: stable periodontal disease with a reduced periodontium (BOP < 10% and PPD < 5 mm) or periodontal disease remission/control. …

Oral complications and management strategies for patients undergoing cancer therapy.

With cancer survival rate climbing up over the past three decades, quality of life for cancer patients has become an issue of major concern. Oral health plays an important part in one's overall quality of life. However, oral health status can be severely hampered by side effects of cancer therapies including surgery, chemotherapy, radiotherapy, and hematopoietic stem cell transplantation. Moreover, prevention and treatment of these complications are often overlooked in clinical practice. The present paper aims at drawing health care professionals' attention to oral complications associated wit

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… The mucosa, the periodontium, and the teeth are the three anatomical sites most commonly associated with these complications [ 24 ]. Oral complications associated with specific oncological therapy will be discussed in the following sections. 3.2. …

Primary Aggressive Oral Lymphomas (PAOL): A Narrative Review of Diagnosis, Molecular Features, Therapeutic Approaches, and the Integrated Role of Dentists and Hematologists.

Primary aggressive oral lymphomas (PAOL) are a rare subset of extranodal non-Hodgkin lymphomas arising in the oral cavity without evidence of other systemic involvement at diagnosis. PAOL accounts for only about 2-3% of all lymphomas. They most commonly belong to aggressive B-cell subtypes such as Diffuse large B-cell lymphoma (DLBCL) and plasmablastic lymphoma (PBL), with occasional cases of Burkitt lymphoma and T-cell/NK-cell lymphomas. Clinically, these malignancies often present with non-specific symptoms (e.g., swelling, pain, ulceration, tooth mobility) that mimic benign dental condition

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… Lymphoma invading the periodontium or jawbone can lead to loosening of teeth out of proportion to local periodontal status. Nerve involvement (e.g., inferior alveolar nerve) may cause paresthesia or a “numb chin” syndrome in mandibular lesions. …

Assessment of evidence from teeth and the alveolar bone of skulls.

A notable lack of agreement on a standardised criterion for representing changes in alveolar bone persists, which limits its application in forensic dentistry. This study aimed to describe the data on loss of tooth substance and alveolar bone in skulls. Dental and trabecular bone information from 28 skulls from the German Helmer skull collection was collected through dental charting, intraoral photographs taken with a DSLR camera (Nikon D5600, Nikon Corporation, Japan), and small radiographs obtained using a handheld dental X-ray device (Nomad Pro 2, Kavo Kerr, Biberach, Germany). Adobe Photos

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… Dentoalveolar trauma affecting teeth, periodontium, and alveolar bone accounts for approximately 15% of emergency room visits, and frequent etiological factors in adults include traffic accidents and physical assault 56 – 59 . …

Osteoprotective Roles of Green Tea Catechins.

Osteoporosis is the second most common disease only secondary to cardiovascular disease, with the risk of fracture increasing with age. Osteoporosis is caused by an imbalance between osteoblastogenesis and osteoclastogenesis processes. Osteoclastogenesis may be enhanced, osteoblastogenesis may be reduced, or both may be evident. Inflammation and high reactive oxygen enhance osteoclastogenesis while reducing osteoblastogenesis by inducing osteoblast apoptosis and suppressing osteoblastic proliferation and differentiation. Catechins, the main polyphenols found in green tea with potent anti-oxida

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… Green Tea Modulates Cytokine Expression in the Periodontium and Attenuates Alveolar Bone Resorption in Type 1 Diabetic Rats PLoS ONE 2015 10 e0134784 10.1371/journal.pone.0134784 26270535 PMC4535908 107. Jin S. Park J.Y. Hong J.M. Kim T.H. Shin H.I. Park E.K. Kim S.Y. …